Evaluation of the therapeutic effects of Aloe vera gel on minor recurrent aphthous stomatitis

Neda Babaee, Ebrahim Zabihi, Saman Mohseni, Ali Akbar Moghadamnia, Neda Babaee, Ebrahim Zabihi, Saman Mohseni, Ali Akbar Moghadamnia

Abstract

Background: Aphthous ulcer is one of the most common diseases of the oral cavity with no known effective treatment so far, which could cause severe discomfort in patients. Aloe vera (A.V.) is a tropical plant with anti-inflammatory and immunostimulant effects, which could be of benefit in a diversity of wound healing conditions. The aim of this study is to evaluate topically administered A.V. gel on oral cavity minor aphthous healing.

Materials and methods: As a double-blind (case control) clinical trial, 40 patients with oral minor aphthous lesions were randomly allocated in either the case group (A.V. gel) or the control (placebo) group. The healing time (days after gel application), patient's pain score; the lesion and its surrounding inflammation diameters were recorded for 2 weeks. The obtained results were analyzed by either "Fishers exact" or t-student test using SPSS software.

Results: The mean (±SD) of patients' age was 29.25 ± 8.48 and 27.95 ± 7.96 years in the control and A.V.-treated groups, respectively, which were not significantly different (P > 0.05). The duration of complete wound healing, pain score, wound size and inflammation zone diameter in the A.V.-treated group were significantly lower than the control group (P ≤ 0.05) on specific time points after treatment.

Conclusion: It seems likely that A.V. 2% oral gel is not only effective in decreasing the recurrent aphthous stomatitis patients' pain score and wound size but also decreases the aphthous wound healing period.

Keywords: Aloe vera; aphthous stomatitis; immunomodulation; mouth diseases.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Stimulated pain score in the Aloe vera or placebo gel treated patients with recurrent aphthous stomatitis. Each point represents the mean ± SE of stimulated pain scores of 20 patients at each day after treatment

References

    1. Woo SB, Sonis ST. Recurrent aphthous ulcers: A review of diagnosis and treatment. J Am Dent Assoc. 1996;127:1202–13.
    1. Jurge S, Kuffer R, Scully C, Porter SR. Mucosal disease series. Number VI. Recurrent aphthous stomatitis. Oral Dis. 2006;12:1–21.
    1. Altenburg A, Zouboulis CC. Current concepts in the treatment of recurrent aphthous stomatitis. Skin Therapy Lett. 2008;13:1–4.
    1. Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: A consensus approach. J Am Dent Assoc. 2003;134:200–7.
    1. Samet N, Laurent C, Susarla SM, Samet-Rubinsteen N. The effect of bee propolis on recurrent aphthous stomatitis: A pilot study. Clin Oral Investig. 2007;11:143–7.
    1. Lee JK, Lee MK, Yun YP, Kim Y, Kim JS, Kim YS, et al. Acemannan purified from Aloe vera induces phenotypic and functional maturation of immature dendritic cells. Int Immunopharmacol. 2001;1:1275–84.
    1. Pakfetrat A, Mansourian A, Momen-Heravi F, Delavarian Z, Momen-Beitollahi J, Khalilzadeh O, et al. Comparison of colchicine versus prednisolone in recurrent aphthous stomatitis: A double-blind randomized clinical trial. Clin Invest Med. 2010;33:E189–95.
    1. Meyer JD, Degraeve M, Clarysse J, De Loose F, Peremans W. Levamisole in aphthous stomatitis: Evaluation of three regimens. Br Med J. 1977;1:671–4.
    1. Feily A, Namazi MR. Aloe vera in dermatology: A brief review. G Ital Dermatol Venereol. 2009;144:85–91.
    1. Rodriguez-Rodriguez E, Darias Martin J, Diaz Romero C. Aloe vera as a functional ingredient in foods. Crit Rev Food Sci Nutr. 2010;50:305–26.
    1. Im SA, Lee YR, Lee YH, Lee MK, Park YI, Lee S, et al. In vivo evidence of the immunomodulatory activity of orally administered Aloe vera gel. Arch Pharm Res. 2010;33:451–6.
    1. Langmead L, Makins RJ, Rampton DS. Anti-inflammatory effects of aloe vera gel in human colorectal mucosa in vitro. Aliment Pharmacol Ther. 2004;19:521–7.
    1. Maenthaisong R, Chaiyakunapruk N, Niruntraporn S, Kongkaew C. The efficacy of aloe vera used for burn wound healing: A systematic review. Burns. 2007;33:713–8.
    1. Reynolds T, Dweck AC. Aloe vera leaf gel: A review update. J Ethnopharmacol. 1999;68:3–37.
    1. Hamman JH. Composition and applications of Aloe vera leaf gel. Molecules. 2008;13:1599–616.
    1. Ynoadmin. Aloe vera. Natural Standard. 2010. [updated 2010; cited 2011 08 Feb 2011]. Available from: .
    1. Richardson J, Smith JE, McIntyre M, Thomas R, Pilkington K. Aloe vera for preventing radiation-induced skin reactions: A systematic literature review. Clin Oncol (R Coll Radiol) 2005;17:478–84.
    1. Cowan D. Oral Aloe vera as a treatment for osteoarthritis: A summary. Br J Commun Nurs. 2010;15:280–2.
    1. Vazquez B, Avila G, Segura D, Escalante B. Antiinflammatory activity of extracts from Aloe vera gel. J Ethnopharmacol. 1996;55:69–75.
    1. Savage NW, McCullough MJ. Topical corticosteroids in dental practice. Aust Dent J. 2005;50(4 Suppl 2):S40–4.
    1. Jettanacheawchankit S, Sasithanasate S, Sangvanich P, Banlunara W, Thunyakitpisal P. Acemannan stimulates gingival fibroblast proliferation: Expressions of keratinocyte growth factor-1, vascular endothelial growth factor, and type I collagen; and wound healing. J Pharmacol Sci. 2009;109:525–31.
    1. Jittapiromsak N, Sahawat D, Banlunara W, Sangvanich P, Thunyakitpisal P. Acemannan, an extracted product from Aloe vera, stimulates dental pulp cell proliferation, differentiation, mineralization, and dentin formation. Tissue Eng Part A. 2010;16:1997–2006.
    1. Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomized controlled trial. Br J Dermatol. 2008;158:573–7.
    1. Atiba A, Nishimura M, Kakinuma S, Hiraoka T, Goryo M, Shimada Y, et al. Aloe vera oral administration accelerates acute radiation-delayed wound healing by stimulating transforming growth factor-beta and fibroblast growth factor production. Am J Surg. 2011;201:809–18.
    1. Sun A, Chia JS, Wang WB, Chiang CP. Immunomodulating effects of “tien-hsien liquid” on peripheral blood mononuclear cells and T-lymphocytes from patients with recurrent aphthous ulcerations. Am J Chin Med. 2004;32:221–34.

Source: PubMed

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